- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,308.54 / $8,477.27 / $15,261.76
| Facility | | $4,308.54 | $8,477.27 | $15,261.76 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,009.64 / $9,767.43 / $11,797.10
| Facility | 50 | $5,009.64 | $9,767.43 | $11,797.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.68 / $9,476.87 / $17,790.50
| Facility | | $6,992.68 | $9,476.87 | $17,790.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.38 / $1,391.22 / $11,920.90
| Facility | | $761.38 | $1,391.22 | $11,920.90 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,788.06 / $9,240.04 / $16,839.00
| Facility | 50 | $1,788.06 | $9,240.04 | $16,839.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,497.20 / $1,537.78 / $1,537.78
| Facility | AS | $1,497.20 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,199.59 / $1,522.47 / $5,275.65
| Facility | | $1,199.59 | $1,522.47 | $5,275.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |